HomeMy WebLinkAboutNCG160109_COMPLETE FILE - HISTORICAL_20050719A (A4 lltii��
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
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DOC TYPE.
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ d U 5 ��7
YYYYM M D D
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Mr. Michael D. Mangum
CC Mangum Company, LLC
PO Box 31768
Raleigh, NC 27622
Dear Mr. Mangum:
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]u1y'15,2005
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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimekp4PrE, Director
Divisiou'trt Water Quality
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Subject: NPDES General Permit NC046A0
Certificate of Coverage NCGJ'6 1d9
CC Mangum Company, LLC-Plant #1
Formerly The Mangum Group
Wake County
Division personnel have reviewed and approved your request to change your name under the General Permit,
received on July 1, 2005.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General
Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of
North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S.
Environmental Protection Agency.
If you have any questions, please contact the Stormwater Permitting Unit at (919) 733-5083, extension 502.
i Sincerely, i.
ORIGINAL SIGNED BY 6
13RADLEY BENNETT 1
Alan W:-Klimek•P>E:"
m DWQ Central Files
'Raleigh Regional Office, Water Quality Section i
Stormwater Permitting Unit
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XhCarolina
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North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone (919) 733-7015 Customer Service
Internet: h2o.enrstate.ne.us 512 N. Salisbury St. Raleigh, NC 27604 FAX (919) 733-2496 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer— 50% Recycled110°h Post Consumer Paper
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG160000
CERTIFICATE OF COVERAGE No. NCG160109
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
CC Mangum Company, LLC
is hereby authorized to discharge stormwater from a facility located at
CC Mangum Company -Asphalt Plant #1
6001 WESTGATE ROAD
RALEIGH
WAKE COUNTY
to receiving waters designated as an unnamed tributary to Sycamore Creek, a class B NSW water in the Neuse River
Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I,
II, III, IV, V, and VI of General Permit No. NCGI60000 as attached.
This certificate of coverage shall become effective July 15, 2005.
This Certificate of Coverage shall remain in effect for,tfie.duration of the General Permit.
Signed this day July 15, 2005.
ORIGINAL SIGNED BY
BRADLEY BENNETT
4
e
Alan W?Klimek,•Difactor
Division of Water Quality
By Authority of the Environmental Management Commission
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ROAD CLASSIFICATION v
Primary highway, Light -duty road, hard or
hard surface. improved surface
Secondary highway,
hard surface, ............ Unimproved road ._--------
Interstate Route U. S. Route State Route
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Colleen H. Sullins, Deputy Director
Division of Water Quality
May 3, 2004
Mr. Don Schell
Mangum Asphalt Services, LLC
P.O. Box 31768
Raleigh, NC 27622
Subject: Stormwater Compliance Evaluation Inspection
Mangum Asphalt Westgate Road Facility
Stormwater General Permit No. NCG160109
Wake County
Dear Mr. Schell:
On April 1, 2004 Jerry Rimmer of the Raleigh Regional Office —DWQ conducted a stormwater
compliance evaluation inspection of the Mangum Asphalt Services, LLC Westgate Road facility
Permit # NCG160109. A copy of the inspection checklist is attached. The assistance Mr.
Richard Smith provided during the inspection was greatly appreciated. His knowledge of the
stormwater program demonstrated the commitment that your company has made to this and
other environmental permit programs. Findings listed on the checklist were as follows:
1. The permit, coverage certificate, SPPP documentation, site plan, site chemical
inventory records and procedures were compliant. Several additions are suggested
below.
2. The material storage piles were well managed. The storage inventory was high, but
the season is just beginning.
3. The oil tank is contained, locked and maintained properly.
4. All stormwater is collected in silt retention basins. This system is maintained and
accessible.
5. The process area has been paved.
6. Discussions with you regarding the analytical program and training indicate that you
are sampling and training per permit. The sample points are acceptable. Analytical
records (Qualitative and Quantitative) need to be maintained at the site for
review. Copies of training plan and records need to be maintained at the site as
well.
7. Annual updates need to be made to the SW plan. A copy of the process/stormwater
review is in plan, but this copy should be signed. A narrative section detailing
tanker off loading procedures and pump valve operations would be helpful to
insure all site personnel avoid potential releases from these operations. A renewal
request was submitted 12/9/03 as this permit expires July 31, 2004.
Your continued attention to the stormwater protection program is appreciated. Although there
are some issues as mentioned above, the discussions engaged in during the inspection and via
telephone should lead to resolution of each of the issues. The stormwater program appears well
Raleigh Regional Office 1628 Mail Service Center
Water Quality Section Raleigh, NC 27699-1628
V.a
Not` hCaro I i na
Aawally
phone (919) 571-4700 Customer Service
facsimile (919) 571-4718 1-877-623-6748
Page 2
Mr. Don Schell
May 3,2004
-..ter' It
organized and is being managed in a timely manner, although documentation is lacking at the
site. We appreciate the commitment given to your stormwater program. If you have any
questions or comments, please call me at (919) 571-4700.
Sincerely,
. ✓wu--�.
Jerrry F. Rimmer
Environmental Specialist
cc: Mr. Richard Smith, Mangum Asphalt, 6001 Westgate Road, Raleigh, NC 27613
NPDES Compliance Unit
Central Files
r
Asphalt Facilities Stormwater Inspection Checklist
Type of Visit ®Compliance Inspection/Program Audit ❑Tech Assistance or Recon
Location: Mangum Asphalt Services, LLC, 6001 Westgate Rd., Raleigh, NC Wake County
Facility Number NCG160109Date 4/1/04 Time In 11:OOAM Time Out 11:40
AM
People Interviewed, and Titles: Richard L. Smith, Plant Manager
Inspector: Jerry Rimmer
SPPP Documentation (Site Plan Part II (A)(1)
1. Copy of Certificate of Coverage ®Yes No Copy of Permit 6Yes pNo Requested but not required
2. General Location (USGS) Map shows plant ®Yes pNo, lines of discharge
Part II(A)(1)(a)
to water of State ®Yes bNo, Stream labeled pYes ENo, Latitude and longitude Eyes pNo
Comments:'.
3. Narrative Description of Practices ®Yes pNo ; _<<. ;='�
Part II(A)(l)(b)
4. Site map Eves pNo Shows flows & areas served with arrows and
Part II(A)(1)(c)
% impervious surface ®Yes pNo, buildings ®Yes pNo, process areas ®Yes ONo,
disposal areas Eyes ONo, drainage structures oNo, existing BMPs such as secondary containment
®Yes ❑No, list of potential pollutants ®Yes ❑No
Comments:,-,--_ '
5. List of significant spills in last 3 years or certif. if none ®Yes pNo none
Part II(A)(1)(d)
PRO called? Dyes ❑No X NA
6. SW outfalls have been evaluated for process water ®Yes ONo No process water.
Part II(A)(1)(e)
7. Feasibility of Changing Practices pYes ENo X NA
Part II(A)(2)(a)
8. Secondary Containment ®Yes ONo Locked Schedule needed! EIYes ®No i " �,
Part II(A)(2)(b)
Records of Draining Containment, Observations Made pYes ONo X NA
9. BMP Summary ®Yes pNo x~4
Part II(A)(2)(c)
10. SPRP Plan Eyes ONo, Responsible personnel still employed here? ®Yes ONo
Part II(A)(3)
11. PM and Housekeeping Plan ®Yes ONo T J Record of Inspections! ®Yes I'd
Part II(A)(4)
12. Employee training HlYes pNo — for everybodYes ❑No See Don Schell
Part Il(A)(5)
13. Responsible parties, chain of command page ®Yes ❑Not _;-�r�;�{
Part ]I A)( 6)
(
14. Plan updated/reviewed annually ®Yes ONo
Part fl(A)(7)
15. Stormwater Facility Inspection Program ®Yes pNo i :.j
Part I[(A)(8)
16. This Plan Has Been Implemented (documents in manual,
Part II(A)(9)
employees show awareness ®YesBNo Commentsf_ ,
Sampling and Analytical Data Part II(C)
All Stormwater and Process Water is Recycled MC(3)) dyes ®No
Rain Gauge on site (not required) pYes ®No
Record of an overflow Oyes ENo Details; _,-'
If not all recycled, what is allowed to discharge? Vehicle Cleaning (IIC2)❑ Recycle overflow (IIC3
above) ❑ Wetting of Aggregate (IIC4)❑ Mixing drum cleanout (IIC5) ❑ Vehicle Maintenance
Note: this checklist does not take the place of your permit. You are fully responsible for
following the permit.
w
For the topics checked in last question, Analytical data present OYes pNo, Compliant? ®Yes ❑No
Details:NA none of the practices done on site.
Total precip pYes pNo, Storm duration 0—Yes ONo, Total flow Est. l7Yes pNo,Field pH ❑Yes ❑No,
Chain of custody pYes pNo
Qualitative Monitoring performed semiannually OYes ONo Records not on site Part Q(F)
Stormwater not combined with process wastewater— general runoff Partil(C)(1)
Analytical data ®Yes pNo, Chain of Custody pYes ONo, Qualitative Monitoring performed
semiannually (Section F) ®Yes [—]No, Don Schell performs sampling and submits data annually to
central files. Needs to keep copy on site for review.
If using cutoff policy, how many sample rounds NA
,.
Cutoff Concentrations me t'Yes [7No jEver have a Bypass. Oyes ONo PartIII (C)(4)a(1 &2)
Notification given? 0Yes.ONo
Outdoor Inspection
I located all discharge points ®Yes ONo No. of areas served 3
Sample points appropriate ®Yes pNo
Location if different from discharze point
Housekeeping: Trash Oyes ONo Dust Oyes ®No ;'`
Take pH Oyes ONo Value(s) -
Take photos OYes ®No
Containment Area satisfactory ®Yes ONo, Loose drums ❑Yes ®No, Locked drain ®Yes ❑No
How is asphalt tank heated?: Natural gas w/ #2oil backup.
Asphalt recovery pile comments Good condition —well maintained.
Inspection Summary Comments
Need to keep training and analytical records on site for review by inspectors and employees.
Chan w/ Withers & Ravenal does sampling & reports.
Recommendations: Need to develop and implement a training plan that mgr. can track.
Need a signed copy of process/stormwater certification and SW plan on site.
Requirements: ;,' pi
Letter is to go to:
Name Don Schell (783-5700 ext. 558.
Address 3141 John Humphries Wynd, P.O. Box 31768, Raleigh, NC 27622
Helpful Information at littp://li2o.enr.state.iic.us/su/Manuals Factsheets hum
Note: this checklist does not take the place of your permit. You are fully responsible for
following the permit.
Revised 03/19/04
A
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C.20460
OMB No. 2040-0057
Water Comd'ance Inspection ReDort
Approval expires 8.31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 jij CJ 2 U 31 "ICci60109 111 121 04/04/01 117 18U 19U 20U
Remarks
21111111111111111111IIIIII1IIIIIIIIIIIIIIIIIII11166
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 OA ---- ------------------ Reserved------------------
67 I 169 70 U 71 U 72 Ll 73 W 74 75I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
Mangum Asphalt Services LLC
11:00 AM 04/04/01
99/08!01
Exit Time/Date
Permit Expiration Date
6001 Wescgace Rd
Raleigh NC 27622
11:40 At4 04/04/01
04/07/31
Name(s) of Onsite Representative(s)/Titles(s)IPhone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Donald J Sche11,n0 Sox 31768 Raleigh NC 27622//919-582-3558/91.9582 Co5n acted
NIX
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Records/Reports M Facility Site Review 0 Storm Water
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
.ferry Ri.mmetRRO WQ//91.9-571-4700/91.9-571-471.8
y I sh)
Signature of Manage ent O A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
R
NPDES yr/mo/day ' Inspection Type
NCG160109 I11 12 I 04/04/01 I17 18 1„I
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
See Attachment
Permit: NCG160109 Owner - Facility: Mangum Asphalt Services LLC - Mangum Asphalt Services LLC
Inspection Date: 04/01/04 Inspection Type: Compliance Evaluation
Vas No NA NF
Permit
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? ❑ ❑ ■ ❑
Is the facility as described in the permit? No ❑ ❑
Are there any special conditions for the permit? ❑ i ❑ ❑
Is access to the plant site restricted to the general public? Y ❑ ❑ ❑
Is the inspector granted access to all areas for inspection? No ❑ ❑
Comment:
State of North Carolina
Department of Environment, /� 0
and Natural Resources-
Division of Water Quality, `fir
James B. Hunt, J&overnorr -
Bill Holman, SecretaryA,,,,. N C D E N R
Kerr T. Stevens, Director . J
�y {o
October 10, 1999
Mr. C. Jackie Williams, Jr.
Mangum Asphalt Services LLC
Post Office Box 31768
Raleigh, North Carolina 27622
Subject: Permit Modification -Name Change
General Permit No. NCG 160000
Cert. of Coverage NCG 160109
(formerly C.C. Mangum, Inc.-Weastgate Plant.)
Wake County
Dear Mr. Williams:
In accordance with your request received on December 16, 1998, the Division is forwarding the subject
permit. The changes in this permit are in regard only to the name of the facility. All other terms and conditions
in the original permit remain unchanged and in full effect. This permit modification is issued pursuant to the
requirements of North Carolina General Statute 143-215 .1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency dated December 6, 1983.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Water Quality or permits required by the Division of Land Resources, Coastal Area Management Act
or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Vanessa Wiggins at telephone number
919/733-5083 ext.520.
Sincerely,
ORIGI
WILLIIAAM C. MILDLS Y
Kerr T. Stevens
cc: Ra el iel igh:Regior af0'ffic�'-�
Central Files
Point Source Compliance & Enforcement Unit
Stormwater & General Permits Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone 919-733-5083 FAX 919-733-9919
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
GENERAL PERMIT NO. NCG160000
CERTIFICATE OF COVERAGE NO. NCG160109
In compliance with the provision ol'Norlh Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Mangum Asphalt Services LLC
Is hereby authorized to discharge slorrmwater from a facility located at
Mangum Asphalt Services LLC
6001 Westgate Road
Raleigh, North Carolina
Wake County
To receiving waters designated as an unnamed tributary to Sycamore Creek, a Class B NSW in the Neuse
River Basin
In accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts
1, II, 111 and IV of General Permit No. NCG160000 as attached.
This certificate of coverage shall become effective December 10, 1999.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day December 10, 1999.
ORIGINAL SIGNED BY
WILLIAM C. MILLS
.................................................................
Kerr T. Stevens, Director
Division of Environmental Management
By Authority of Environmental Management Commission
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
C.J. WILLIAMS, JR.
MANGUM ASPHALT SERVICES, LLC
P.O. BOX 31768
RALEIGH, NC 27622
Dear Permittee:
1L
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
July 27, 1999
Subject: Reissue - NPDES Stormwater Permit
Mangum Asphalt Services, LLC
COC Number NCG160109
Wake County
In response to your renewal application for continued coverage under general permit NCG160000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued Stormwater general permit. This permit is reissued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983.
The following information is included with your permit package:
* A copy of general Stormwater permit NCG160000
* A Stormwater Pollution Prevention Plan (SPPP) Certification Form. Completion of this form is required to
certify that you have developed and implemented the SPPP as per the conditions of the permit. This form
must be completed and returned to the Division within 30 days of receipt of this letter.
DO NOT SEND the SPPP with the signed form.
* Five copies of the Analytical Monitoring form and five copies of the Qualitative Monitoring form
* A copy of a Technical Bulletin for the general permit which outlines changes in the permit, key requirements.
and addresses frequently asked questions
* A Certificate of Coverage
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, slate, or local law, rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit package please contact Tony Evans of the Central Office Stormwater
and General Permits Unit at (919) 733-5083, ext. 584
Sincerely,
for Kerr T. Stevens
cc: Central Files
Stormwater and General permits Unit Files
Raleigh Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone 919-733-5083 Fax 919-733-9919
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG160000
CERTIFICATE OF COVERAGE No. NCG160109
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
MANGUM ASPHALT SERVICES, LLC
is hereby authorized to discharge stormwater from a facility located at
MANGUM ASPHALT SERVICES, LLC
6001 WESTGATE RD
RALEIGH
WAKE COUNTY
to receiving waters designated as a UT of Sycamore Creek in the Neuse River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 11.111,
IV, V. and VI of General Permit No. NCG160000 as attached.
This certificate of coverage shall become effective August 1, 1999.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 27, 1999.
for Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission
'State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
January 5, 1996
Joseph L Etheridge
C C Mangum Inc -Westgate Plant
P.O. Box 31768
Raleigh, NC 27622
® FEE HIVF -: I
1
QEN�K
Subject: General Permit No. NCG 160000
C C Mangum Inc -Westgate Plarir=
COC NCG 160109
Wake County
Dear Joseph L Etheridge:
In accordance with your application for discharge permit received on November21, 1995, we are
forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general
permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .l and
the Memorandum of Agreement between North Carolina and the US Environmemt:! Protection agency dated
December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division
of Environmental Management. The Division of Environmental Management may require modification or
revocatinn and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Environmental Management or permits required by the Division of Land Resources, Coastal
Area Management Act or any other Federal or Local governmental permit that may be required.
If you have any question concerning this permit, please contact MR. ANTONIO EVANS at telephone
number 919/733-5083.
Sincerely, ORIGIM SIGNED By
BRADLEY BENNETT
A. Preston Howard, Jr. P.E.
cc: Raleigh Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone 919-733-7015 FAX 919-733-2496
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10 % post -consumer paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
GENERAL PERMIT NO. NCG160000
CERTIFICATE OF COVERAGE No NCG160109
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
C.C. Mangum. Inc.
is hereby authorized to discharge stormwater from a facility located at
C.C. Mangum, Inc.
6001 Westgate Road
Raleigh, NC
Wake County
to receiving waters designated as an unnamed tributary to Sycamore Creek, Class 13 NSW in the Neuse River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 11, III
and IV of General Permit No. NCG160000 as attached.
This certificate of coverage shall become effective January 5, 1996.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January 5, 1996. ORIGINAL
BRADIEYggNNcII
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission
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ROAD CLASSIFICATION v
Primary highway, Light duty road, hard or
hard surface .."............ unproved surface ss ti
Secondary highway,
hard surface ......._.— Unimproved roac _-------- '
Interstate Route U S. Route State Route ,
Asphalt Facilities Stormwater Inspection Checklist
Type of Visit []Compliance Inspection/Program Audit ❑Tech Assistance or Recon
�t
Location /fA 9u t�Tf.�// rc �: ,or GGc 6007�osJJam/o R�. . yc
lr c�
Facility NumberNCG16 p/py Date!f/�/U}� TimeIn'/,/, U�IimeOut
/l,,yp
People Interviewed, and Titles: It j tl,',, wt,;,.Jt P/ foio
Inspector: 'S'?Jl. R(10', -V
SPPP Documenttion (Site Plan Par -II (A)(1)
des pNo ' Permit Requested
but
1. Copy of Certificate of Coverage Copy of es ONo
not required
2. General Location (USGS) Map shows plant 9 es pNo, lines of discharge Part II(A)(1)(a)
to water of State &es ®No, Stream labeled OYes pNo, Latitude and longitude li�� s ONo
Comments:,= ,'
3. Narrative Description of Practices es ONo
Part II(A)(1)(b)
4. Site map Lj'fes ❑No Shows flows & areas served with arrows and
Part II(A)(1)(c)
% impervious surface ( es pNo, buildings Yes ONo, process areas d es O'No,
di osal areas p eO s pNo, drainage structures 2Yes No, existing BMPs such as secondary
�.
containment
es ONo, list of potential pollutants ❑Yes ONo
Comments L_ '!
5. List of significant spills in last 3 years or certif. if none (Yes ❑No f R
Part II(A)(1)(d)
RRO called? OYes ONo
6. SW outfalls have been evaluated for process water (K'es ONo s'_
Part II(A)(1)(e)
7. Feasibility of Changing Practices pYes ONo:,",
Part 11(A)(2)(a)
8. Secondary Containment & es pNo �y f, Schedule needed? pYes bf'oj
Part II(A)(2)(b)
Records of Dr ning Containment, Observations Made OYes ONo
9. BMP Summary es ONo,,.
Part II(A)(2)(c)
10. SPRP Plan es ONo Responsible personnel still employed here? .,,.. es ONo `
Part II(A)(3)
11. PM and Housekeeping Plan pies ONo. , `.;'] Record of Inspections? (�s pNo
Part II(A)(4)
verybody Yes pNo ;� O� sC t, //
2 12. Employee training pYes pNo — fjal
Part II(A)(5)
13. Responsible parties, chain of cod page (Yes pNo 1, ,µ; . ,(
Part II(A)(6)
14. Plan updated/reviewed annually s ONo mY
Part II(A)(7)
15. Stormwater Facility Inspection Program &es ONo ..;
Part II(A)(8)
16. This Plan Has Been Im lemented (documents in manual,
Part II(A)(9)
employees show awareness es pNo Comments:,,*
Sampling and Analytical Data Part II(C)
All Stormwater and Process Water is Recycled (IIC(3)) OYes o
Rain Gauge on site (not required) Oyes 6?6
Record of an overflow pYes pNo Details
If not all recycled, what is allowed to discharge? Vehicle Cleaning (IIC2) ❑ Recycle overflow (IIC3
above) ❑ Wetting of Aggregate (IIC4)❑ Mixing drum cleanout (IIC5) ❑ Vehicle Maintenance ❑
Note: this checklist does not take the place of your permit. You are fully responsible for
following the permit.
i-�1 aa�
�J :11�►5� ����� bow Soo �y%.ss
L el M
For the topics_ checked in last question, Analytical data present Dyes ONo, Compliant?'Yes ONo
Details e
Total precip OYes'No, Storm duration pYes ONo, Total flow Est. ElYes ONo,Field pH byes ONo,
Chain of custody QYes ONo
Qualitative Monitoring performed semiannually'Yes pNo Part II(F)
Stormwater not combined with process wastewater — general runoff Partfl(C)(1)
Analytical data 2Yes ❑No, C in of Custody pK es pNo, Qualitative Monitoring performed
semiannually _5ecti n F) s �jNoo
f ., /'A'11621?toy
If using cutoff policy, how many sample rounds, -
Cutoff Concentrations met'Yes pNo , , ',,Ever have a Bypass? Oyes ❑No PartIII (C)(4)a(1 &2)
Notification given? Dyes ONo
Outdoor Inspection
I located all discharge points Yes ONo No. of areas served
Sample points appropriate Oyes ONo '" ad'
"
Location if different from discharge point -r' j
Housekeeping: Trash 'Yes LaNVo Dust Oyes pNo
Take pH EiYes bf o Value(s) ;sJ
Take photos QYes C�Ko
Containment Area satisfactory 6Yes pNo, Loose drums pYes T ' o, Locked drain L es pNo
How is asphalt tank heated?: g/
Asphalt recovery pile comments
Inspection Summary Comments
Recommendations:,
Requirements::'.
Letter is to go to:
Name.
Title:
dh s-/!-e
r,'y-e
Address. -
Helpful Information at littp•//li2o enr state.iie.tis/su/ManLials Factsheets.htm
Note: this checklist does not take the place of your permit. You are fully responsible for
following the permit.
Revised 03/19/04